ArticlePain reports2026
Repetitive tooth-clenching triggers kynurenine pathway activation in masseter muscle of women with temporomandibular disorders myalgia.
Article in Pain reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Inflammation alters the kynurenine pathway (KP), producing metabolites related to pain regulation. Previous microdialysis studies indicate increased levels of inflammatory markers in temporomandibular disorders myalgia (TMDM) that increase in response to tooth-clenching. This study aimed to elucidate the role of the KP in TMDM by investigating intramuscular KP metabolites in response to tooth-clenching. Methods: This study included 41 women; 15 TMDM myofascial pain with referral (MFP), 13 TMDM local myalgia (MYA), and 13 controls (CTR). Microdialysis was applied to the masseter muscle for 220 minutes to analyze tryptophan (TRP), l-kynurenine (KYN), 3-hydroxykynurenine (3-HK), quinolinic acid (QUIN) and nicotinamide (NAM). After baseline (140 minutes), participants performed a 20-minute tooth-clenching exercise followed by 1 hour of recovery. Pain variables were assessed throughout the experiment. Results: NAM levels increased significantly in response to tooth-clenching across all groups ( Conclusion: These findings indicate that intramuscular KP metabolites increase in response to tooth-clenching, particularly in MFP, distinguishing them from both CTR and MYA. This supports the link between intramuscular inflammation and exercise-induced alterations in the KP, providing further insights in the TMDM pathophysiology and differentiation of its subdiagnosis.
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